Significance of Evidence Based Practice in Nursing

Significance of show up Based Practice in nursingNursing is a profession accountable to society for providing high character reference cost-effective explosive charge for patients and their families (Burns Grove, 2007). This assignment will define rise found practice and its significance in the nursing process. In addition, it will critically analyse the interrogation phrase Community Psychiatric Nurses contract of operative with people who engage in deliberate egotism harm carried stunned by Thompson et al (2008). Furthermore it will define Hierarchy of Evidence and its importance in re face studies. A clinical question has been explicate using creation, Intervention, Comparison and Outcome (PICO) and the pigment words in the phrase to wait for a nonher article which support or contradicts the main come off article.Brown defines register based practices as the utilisation of the trump grapheme interrogation to deliver an effective part of cargon in the best i nterest of the patient as vigorous as promoting cost intensity level within the advantageouslynesscare system (Brown, 1999). In order for health care professionals to deliver the best quality of care, they need to use the combination of enjoin based clinical treatments and practices (Lindsay, 2007).Evidence based knowledge is grand as it guides and maintains the clinical competencies of health care practitioners and provides a re anticipate based explanations to tending patients in the process of clinical decision making (Burns and Grove, 2007). accord to Ciliska et al (2005), the skills necessary to provide evidence based solution to a clinical dilemma includes defining the problem, conducting the effective research to locate the best evidence, critically appraising the evidence and considering that evidence and its implications in the context of patients circumstances and values. interrogation into the experience of community psychiatrical nurses works with people who enga ge in deliberate self-harm was carried out using the qualitative research design, as it is earlier concerned with understanding human beings experiences in a humanistic, interpretive attack (Ronald et al, 2007). The purpose of the research was to understand CPNs experience while they are working with people who deliberately self-harm. In this research it was found suitable as it relies less on non numerical data.A study by Playle (2000) insinuate that articulateers need to read, critically study and judge a research article to demonstrate their understanding of research and to identify implications for practice. In this study, Tarling and Crofts (2002)s framework and The scathing Appraisal Skill Programme (CASP) accessed on http//www.phru.nhs.uk/Pages/PHD/CASP.htm has been apply to review the strength, credibility, asperity and failing of the above study.The title Community Psychiatric nurses experience of working with people who deliberately self-harm is clear, concise and informative as it reflects the contents of the totally study. Informative titles are important in research process as it allows the reader to identify the research approach (Roe and Webb, 1999), however the title does not reveal the approach which flannelthorn be seen as a weakness (Dempsey and Dempsey, 2000).The authors of this article are qualified professional with clinical and psychological expertise as wellspring as experience of working with people with psychic health problems as Dempsey and Dempsey (2000) suggests that authors should be qualified to carry out a research study and their qualifications should be verified if need be. This may be seen as powerful, hence reliability and credibility of this article is not equivocal as they will be perceived as professionals with clinical credibility to eliminate bias (Hoskins et al, 2005). However it can be argued that the community psychiatric nurses had not undertaken psychotherapy training although they had a minimum o f eighteen age of experience (Thompson et al, 2008).The abstract is short, brief and concise. According to Parahoo (2006) a research cross should begin with an abstract which summarises the major findings of the study as well as attracting the readers attention to read the whole research article thus adding credibility and validity to the report. Lack of clear summary may be seen as a weakness as readers may lose interest in reading the whole article as it may fail to evince the important information about the study (Morrison, 1992).According to Newell Burnard (2006), an introduction should clear define the key words and stating the purpose of the research. This study clearly explains in detail what is meant by deliberate self-harm and yet there is little research into the actual experience of working with people who deliberate self-harm (Thompson et al, 2008).The research used Interpretative Phenomenological Analysis (IPA), which allowed an in-depth exploration of individual p ersonal experience, underpinning the theory of rendering and interaction which focuses on individuals experiences to the central concern and can only be accessed through IPA (Smith, 1995). According to Streubert and Carpenter (1995), Interpretative is the understanding of life experiences and events and Phenomenology is the coming into court of things as lived experiences. This may be seen as strength as it is basically important, as without knowing exactly how the study was carried out, it is difficult for the reader to legal expert its strengths and weaknesses (Gillis, 2002). In this study, the police detectives and the participants were all from the North of England thereby eliminating the theory of ethnography which requires the tec to learn about a culture and be part of it (Burns and Grove, 2007). The participants were make up of four male and four females from the community mental health teams who had an average age of forty old age and eighteen years of experience of wo rking with people who engage in deliberate self -harm. The researcher did not explain why different age groups did not record or other ethnic minority groups which limited their findings.For the purpose of this study, a purposive (participants with a specific characteristics (Lindsay, 2007) sample was recruited. According to Parahoo (2006), sampling is important in qualitative research as it seeks to collect valid and trusty data from a small division of the population that would be congresswoman of the whole population. This showed to be suitable to the study which may be seen as reliable and valid although, it can be argued that sampling method may call down biased results. It may be seen as a discriminating method to fulfil the aims of the study (Streubert-Speziale Carpenter, 2007).Data was collected through semi-structured call into question and open-ended questionnaires according to IPA (Smith, 1995). The interviews lasted for forty five minutes to an hour which was cha nnelise but did not dictate the exact course of the interview. This was chosen in order to allow the interviewees to talk freely to explain their thoughts and experiences. The method accessed the participants indispensable attitudes and understanding of deliberate self harm. This enabled certain responses to be questioned in great depth, while collecting similar data from all the informants as well as creating a relaxed comfortable environment for the interviewees, (Holloway and Wheeler, 2002).However it can be argued that it is a time-consuming method, not just the collecting of the data, but the transcribing and depth psychology of the data. There are risks of interviewer bias as face to face interviews frequently require training, (Parahoo, 2006).All interviews were recorded and transcribed verbatim. According to Holloway and Wheeler (2002), researchers must preserve participants words as accurately as possible before analysing the data. The researchers had a chance to repla y the tapes several times to improve the quality of the transcripts.The transcripts were then analysed using IPA principals (Smith and Osborn, 2003). The researcher read the transcripts to familiarise with the data, noting down the key words and phrases said by the participants, thus summarising the sample (Rowntree, 1991). The notes were classified in more general term to form initial themes to try and flummox the essence of the participants accounts which were then copied to a computer program which assisted in managing connections between the emerging themes but no direct digest was made.According to Morse and Field (2007), transcripts from different informants should be compared categorised and coded into substantive themes and sub-themes to produce a high degree of interpretation and integration. A master inclining of themes and subthemes was then produced for transcript which contained a degree of interpretation and integration. The process was retell on every interview to maintain consistence of data analysis as suggested by Burns and Grove (2007). The themes were highly developed and compared to genuine text as Speziale Streubert and Carpenter (2007) suggests that researchers needs to move forward and averse between levels until saturation is achieved to ensure a comprehensive understanding of the phenomena.A table was produced for each theme indicating the sub themes and identifying where each transcript could be evidenced. Different methods were employed to ensure trustworthiness and the master themes audited by the three nearly authors including an independent researcher to ensure that themes were warrantable and grounded in the data.Although the researchers hand over carefully considered how to ensure validity of the study, it is noted that the findings were subject to limitations as all the nurses were experienced white British, limiting the applicability of nurses from other ethnic origins or trained in other countries. In addition, it is a small study based in a small geographical area which limits reliability as well as the generalizability of the results (Meadows, 2004).There is also evidence that there may be differences in assessment practices between different professional groups and different levels of experience, (Weston, 2003). Furthermore, the findings are based on reflective accounts of the experience of working with patients, who self-harm and may therefore be subject to memory bias, (Thompson et al, 2008). The authors recommends further studies to explore the extent of experiences and evaluate further interventions to improve professional awareness of deliberate self-harm as well as training for nurses to provide high standards of care as suggested by NMC (2008).The researcher sought approval from the NHS (National Health Service) ethical and research political science as suggested by Parahoo (2006) thus adding credibility. However the research does not trace if consent, was sort from the participants which may appear as a weakness as it important to respect for autonomy and beneficence (Polit and Beck, 2006). Ensuring of confidentiality NHS (2008) of information discussed, was not intercommunicate to the participants before the research was carried out which may have led to refuse of important information which would affect the validity of the report (Clifford, 1997). This can be seen as a weakness in the research.Hierarchy of evidence is the be of research methods according to their effectiveness, strength and weaknesses (Ciliska et al, 2005). In the healthcare system, depending on its source, some research methods are considered to be stronger and produce better quality evidence than others hence credibility, reliability and validity differs (Lindsay, 2007). According to Polit Beck (2008), qualitative research waterfall on level V because of its systematic descriptive of psychological studiesCraig and Smyth (2002) suggests the use of PICO (systematic way to identify impor tant ideas in a research article), in formulating a clinical question in health care.P is Population which was Deliberate Self harmI is Intervention which was Not applicableC is Comparison which was Not ApplicableO is Outcome which was CPN experience.To search for the second article clinical question has been formulated using PICO. The sideline link was used to access the article.Student Portal Log In my studies summon type in key words Go Button.The search was carried out using the key words, CPNs experience in deliberate self harm in all fields and 310 articles were retrieved. The search was limited to point of intersection content journals only which retrieved 306 journals. The search was further limited with the number of years from 2009 to 2010 which yielded 35 journals articles. Among the articles, Analysis of Accident and Emergency Doctors Response To Treating People Who Self-Harm was retrieved and read through which supported the reviewed article adding to its strength, va lidity and credibility. A study by Craig Smythe (2002) suggests the search of electronic database as a method of finding research studies as all journals have indexes that have been converted to electronic databases. The University indorse to Summon which can be accessed freely by all students which makes it easier to search articles for educational purposes.In conclusion, evidence based knowledge is important in implementation of cost effective nursing intervention and therefore it is the province of health care professionals to critically analyse any piece of evidence for credibility, validity, reliability and its source, in clinical decision making (Brown ,1999). They also have a legal and professional responsibility under the Human Rights cause 1998, Health and Safety 1974, The Consumer Protection 1987 as well as The vocation of Care (NMC 2008).